Organization
LUZERNE/WYOMING COUNTY MH CENTER #1
Active
Parent organization
LUZERNE/WYOMING COUNTY MH CENTER #1
Other names
Blended Case Management
Organization subpart
Yes
Provider details
NPI number
Legal business name
LUZERNE/WYOMING COUNTY MH CENTER #1
Authorized official
FRANK PIAZZA (CONTROLLER/MIS DIRECTOR)
(570) 552-3625
Entity
Organization
Contact information
Practice address
110 S PENNSYLVANIA AVE, WILKES BARRE, PA 18701-3301
(570) 552-6000
Mailing address
562 WYOMING AVE, KINGSTON, PA 18704-3721
(570) 552-3625
(570) 552-3907
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002080
—
PA
Enumeration date
02/24/2009
Last updated
02/24/2009
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